Midsumma Patron Registration
Please enter your preferred first name then your family name, in that order.
Organisation / Company
Only relevant if your company or organisation is paying the patron fee
Preferred phone number for contact during business hours
Mobile phone number
What is the total amount of your tax-deductible donation?
Midsumma has four levels of patron: Diamond Patron ($5,000+), Gold Patron ($2,000 – $4,999), Silver Patron (1,000 – $1,999) or Rainbow Patron ($500 – $999).
Do you wish for your patronage to remain anonymous?
Unless you tick the box below, you will be recognised in the Midsumma Printed Program guide and online
Please keep my donation anonymous
How would you like to make your payment?
I'd like to pay online (the confirmation page will give you the link)
I will phone the Midsumma office on 03 9296 6600 with my credit card details
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This form was created inside of Midsumma.
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